Kids On Medicaid To Be Tested For Lead

September 13, 1992|By New York Times

WASHINGTON — Responding to new medical concerns about the harmful effects of exposure to even low levels of lead, the federal government is requiring that virtually all young children on Medicaid be screened for lead poisoning.

But the federal directive allows states to continue using a test known to be inaccurate in measuring small amounts of lead in the blood.

The new policy, in instructions to state Medicaid officials that will take effect later this month, is intended to prod states to be more aggressive in testing children for lead poisoning.

The policy reflects the conclusion of federal health officials that levels of lead once thought to be safe can cause mental retardation, learning disabilities, stunted growth, hearing loss and behavior problems in children.

''All children ages 6 months to 72 months are considered at risk and must be screened for lead poisoning,'' say the instructions from the Federal Health Care Financing Administration, which supervises the Medicaid program for low-income families. ''Complete lead screening consists of both a verbal risk assessment and blood tests.''

Lead poisoning is one of the most common health problems among children in the United States. The government says it afflicts 3 million to 4 million young children - one in six youngsters under 6 years old.

At highest risk are low-income children, the very ones entitled to screening under Medicaid. Many of them live in old, dilapidated, inner-city housing projects with peeling lead-based paint. But the government has emphasized that ''no socio-economic group, geographic area or racial or ethnic population'' is exempt from the risk of lead poisoning.

The new directive will affect hundreds of thousands - and eventually millions - of children. More than 6 million children under age 6 are on Medicaid. Experts say fewer than half have been screened for lead poisoning.

More extensive testing presumably will find more children who need treatment. But neither federal nor state officials could estimate the cost.

Until now, criteria for screening, like many details of the Medicaid program, varied from state to state.

In October 1991, the Public Health Service said there was ''overwhelming and compelling'' evidence that children had been harmed by lead in concentrations as low as 10 micrograms per deciliter of blood. The test widely used for the last 15 years is not sensitive enough to detect levels that low.

The new rules acknowledge that ''it will take some time for states to make a transition'' to a more accurate, more expensive test for lead poisoning, known as a blood lead test. This is clearly ''the screening test of choice,'' the government said.